Promoting early relational health and resilience in pediatric primary care: a qualitative study.

BACKGROUND

Efficacy of health-care based Early Relational Health (ERH) parenting interventions like PlayReadVIP and Smart Beginnings, are well-established, but limited research has examined parental perceptions of impact.

OBJECTIVE

To explore parents' perceptions of how PlayReadVIP and SB support their parenting, generally and during the COVID-19 pandemic.

METHODS

Nested sample of low-income parents enrolled in a two-site RCT of Smart Beginnings (SB), in New York City, NY (n = 40, 93% Latino) and Pittsburgh, PA (n = 40, 80% Black) and a single-site RCT of PlayReadVIP, Supporting Parents And Raising Resilient Kids (SPARRK), in Flint, MI (n = 40, 45% Black, 38% White). Interviews were audio taped and transcribed. Transcripts were coded using an iterative process of textual analysis until thematic saturation was reached.

RESULTS

Four themes emerged: (1) Caregivers valued learning new, foundational parenting practices; (2) became more child-centered; (3) felt increased self-efficacy and empowerment; and (4) identified PlayReadVIP and SB as sources of support.

CONCLUSIONS

Parents valued the ERH-aligned skills and concepts they learned in PlayReadVIP and SB and viewed the programs as sources of social support. Findings can inform and strengthen pediatric primary care-based parenting programs and have implications for feasibility, acceptability, and scaling of evidence-based and layered ERH programs.

CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov, NCT02459327, NCT03945552 https://clinicaltrials.gov/study/NCT02459327 , https://clinicaltrials.gov/study/NCT03945552 .

IMPACT: Qualitative study demonstrating that parents value and learn Early Relational Health (ERH) skills from health-care based preventive parenting interventions. Findings inform adaptation, engagement, and scaling. Efficacy of parenting interventions (PlayReadVIP, Smart Beginnings) are well-established, but limited research has examined parental perceptions of impact. This study explores parents' experience with these programs to better understand core components and identify areas for adaptation and refinement. This study builds on prior quantitative work to demonstrate parents' perceived impact of and value in PlayReadVIP and Smart Beginnings. Parents reported participation in these programs/models resulted in enhancements to ERH, mind-mindedness, social support, and mental health.